PMID- 11028112
OWN - NLM
STAT- MEDLINE
DCOM- 20001116
LR  - 20101118
IS  - 1330-0164 (Print)
IS  - 1330-0164 (Linking)
VI  - 54
IP  - 2
DP  - 2000
TI  - Slow continuous renal replacement therapies: an update.
PG  - 69-84
AB  - Continuous renal replacement therapies (CRRT) are now being used by 
      nephrologists, intensivists, and anesthesiologists. The various CRRT modalities 
      differ in the kind of vascular access, the application of diffusive or convective 
      clearances (or a combination of both), and in the location where the replacement 
      fluid enters the circuit. CRRTs have certainly made the management of critically 
      ill patients with acute renal failure (ARF) combined with cardiovascular 
      instability, severe fluid overload, hypercatabolism, cerebral edema, adult 
      respiratory distress syndrome, lactic acidosis, sepsis or other inflammatory 
      syndromes, crush syndrome, congestive heart failure, and cardiopulmonary bypass 
      easier. Continuous therapies incorporate several advantages including improved 
      hemodynamic stability, optimal fluid balance, gradual urea removal, elimination 
      of septic mediators, and the possibility of unlimited parenteral nutrition. Major 
      difficulties and unsolved problems of CRRT are the ongoing necessity of 
      continuous anticoagulation, considerable loss of amino acids, vitamins, trace 
      elements, potassium, phosphate, and some drugs, as well as immobilization of the 
      patient. The advantages of CRRT should theoretically translate into improved 
      outcomes of critically ill ARF patients, but the superiority of continuous 
      modalities in terms of outcome is still controversial, despite encouraging 
      results in some clinical trials. Currently used CRRT with sophisticated treatment 
      devices has become more expensive than hemodialysis, but the cost cannot be used 
      as an argument against the continuous treatment modalities.
FAU - Kes, P
AU  - Kes P
AD  - Department of Nephrology and Dialysis, Sestre Milosrdnice University Hospital, 
      Zagreb, Croatia.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Croatia
TA  - Acta Med Croatica
JT  - Acta medica Croatica : casopis Hravatske akademije medicinskih znanosti
JID - 9208249
SB  - IM
MH  - Acute Kidney Injury/*therapy
MH  - *Hemodiafiltration/methods
MH  - *Hemofiltration/methods
MH  - Humans
MH  - *Renal Dialysis/methods
RF  - 64
EDAT- 2000/10/12 11:00
MHDA- 2001/02/28 10:01
CRDT- 2000/10/12 11:00
PHST- 2000/10/12 11:00 [pubmed]
PHST- 2001/02/28 10:01 [medline]
PHST- 2000/10/12 11:00 [entrez]
PST - ppublish
SO  - Acta Med Croatica. 2000;54(2):69-84.